Open AccessReasons for hospitalization in HIV‐infected children in West Africa
Author(s) -
Dicko Fatoumata,
Desmonde Sophie,
Koumakpai Sikiratou,
DiorMbodj Hélène,
Kouéta Fla,
Baeta Novisi,
Koné Niaboula,
Akakpo Jocelyn,
Sy Haby Signate,
Ye Diarra,
Renner Lorna,
Lewden Charlotte,
Leroy Valériane
Publication year - 2014
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.17.1.18818
Subject(s) - medicine , case fatality rate , pediatrics , observational study , human immunodeficiency virus (hiv) , cohort , emergency medicine , population , family medicine , environmental health
Current knowledge on morbidity and mortality in HIV‐infected children comes from data collected in specific research programmes, which may offer a different standard of care compared to routine care. We described hospitalization data within a large observational cohort of HIV‐infected children in West Africa (IeDEA West Africa collaboration). Methods We performed a six‐month prospective multicentre survey from April to October 2010 in five HIV‐specialized paediatric hospital wards in Ouagadougou, Accra, Cotonou, Dakar and Bamako. Baseline and follow‐up data during hospitalization were recorded using a standardized clinical form, and extracted from hospitalization files and local databases. Event validation committees reviewed diagnoses within each centre. HIV‐related events were defined according to the WHO definitions. Results From April to October 2010, 155 HIV‐infected children were hospitalized; median age was 3 years [1–8]. Among them, 90 (58%) were confirmed for HIV infection during their stay; 138 (89%) were already receiving cotrimoxazole prophylaxis and 64 children (40%) had initiated antiretroviral therapy (ART). The median length of stay was 13 days (IQR: 7–23); 25 children (16%) died during hospitalization and four (3%) were transferred out. The leading causes of hospitalization were WHO stage 3 opportunistic infections (37%), non‐AIDS‐defining events (28%), cachexia and other WHO stage 4 events (25%). Conclusions Overall, most causes of hospitalizations were HIV related but one hospitalization in three was caused by a non‐AIDS‐defining event, mostly in children on ART. HIV‐related fatality is also high despite the scaling‐up of access to ART in resource‐limited settings.